MIDWIFERY EDUCATION

in 18th century London

Anna Bosanquet(supervisors: Hilary Marland and Claudia Stein)

BACKGROUND• Century of great social,

economic, political changes, affecting

• daily lives of women, including their experience of childbirth

• working lives of midwives and doctors, including their training, knowledge and practice

PROFESSIONAL RIVALRIES

Old tradition: a female midwife

New species:a man-midwife

TRADITIONAL HISTORYnegative view of a female midwife

J. Aveling ENGLISH MIDWIVES: THEIR HISTORY AND PROSPECTS. 1872, reprinted 1967

• ‘Very little is known of the early history of the English Mid-wif’... It is certain, however, that she was a woman of inferior education’.

• Superstitious, elderly, drunk and dirty women:

• ‘Ignorant of anatomy, and obviously unreliable in emergencies, they contributed considerably to the maternal and neo-natal death-rates; yet they flourished for lack of alternative facilities.’

THE ENGLISH

MIDWIFE?

Challenges to triumphalist medical history since 1980s

• Donnison• Marland• Versluysen• Evendeen• Croxson• Cody• Wilson• Harley • Grundy• Tew• Schofield

MIDWIFE TRAINING BEFORE THE 18TH

CENTURY• Traditional apprenticeship• Long period of training –

majority 5-10 years; (3-30!)• High literacy levels• Testimonials and witnesses• England different to the

Continent and Scotland• No structured / national

training• Various failed proposals• Always political:

humanitarian efforts but also vested interests and hidden agendas

RESEARCH QUESTIONS• What types of midwifery courses

and training were available for men and women in 18th century London?

• What was their content, structure, and what teaching methods were used?

• Who were the midwifery pupils and what was their experience?

• What were the consequences of new training methods for the professional standing of a female midwife?

SOURCES 1

• Midwifery textbooks, manuals and course syllabi published by man-midwives and female midwives

SOURCES 2

• Hospital archives, including minutes of Board meetings and published reports

SOURCES 3

• Hand-written lecture notes taken by midwifery pupils

• Personal letters describing training

SOURCES 4

• 17th-18th century Burney Collection newspapers

SOURCES 5

•Secondary analysis of original data provided by other scholars and re-analysis of published data

Lisa Cody: private communicationSusan Lawrence: 1996

Year accepted Last Name First Name

Husband's Name

AgeHusband's Occupation Cross References Address/Town Region/County

Widow spinster

1753 Fiddes Elizabeth George 36           1753 Fletcher                  1754 Hall Margaret John 28           1754 Nettlefold Mary John 30           1754 Russell Anna Maria   26           

1754 Preest Mary Richard 38Apothecary  Kingston-upon Thomes (late of) Surrey x  

1754 Butler Jane Pierce 30Surgeon and Apothecary

Appointed Matron of the British Lying-in Hospital

Chancery Lane, London London    

1755 Emerton Sarah John 36Mariner  

Hamlet of Ratcliff in the Parish of Stepney Stepney    

1755 Evans Ursula Charles 36Farmer  

Wellington in the County of Hereford Hereford    

1756 Brightwell Agnes John 27Superviser of the Excise  

Basingstoke in the County of Hants Hants x  

1756 Boadger Catherine William     Former patient        1757 Gyfford Elizabeth Edward 27Apothecary   Barking Essex x  

1758 Blackstock Mary Edwardsister of Matron, Mrs. Oakes

1758 Case Mary William 44Surgeon Lynn Norfolk1758 Prick Abigail John 40Bricklayer Queenborough Kent

1758 Tuffin Mary Charles 25

Cornet in the Regiment of Horse called the Oxford Blues

1759 VacryMaria Margaretta Nicholas John 40Surgeon

Albemarle Row, London London x

1760 Wright Susanna John 30Yeoman Feniton Devon x

1760 Webb Mary William 29Carpenter

St. Dunstan in the West, London London

1760 Fearnall Martha William 34Tallow Chandler Oakingham Berks1760 Randall Anna Maria Edward 30Yeoman Chawton Southampton1760 Maynard Mary William 30Hair Merchant Gloucester Gloucester x1760 Haynes Mary 25 x

1761 Turner Jane James 32Silver-Smith

late of St. Martin's Lane; but now of Jamaica Jamaica

1761 Powell Mary Henryc 42Coach Keeper

Old Bethlehem, London London

1761 Middleton Sarah Thos. 43Cabinet Maker Gosport Hampshire1761 Ring Mary James 25Mason Basinstoke Southampton1762 Coates Anne William Apothecary Theal Berks1762 Higgs Mary William Tallow Chandler St. Mary le Bone London1762 Boxall Ann John 35Carpenter Plestow Sussex1762 Williamson Esther John 41Mariner York x

1762 Cartwright Ann Jeremiah 31Mason of the HayCounty Brecknock

1763 Allen Elizabeth William 41Joyner   Egham Surrey    1763 Ross Elizabeth William 30Merchant   Aberdeen Scotland    

1763 Garlick Ann William 28Maltster  

Stelmet Court, in the Strand, London London    

1763 Yewd Ann Thos.   Secretary to this Charity

Wife of the Secretary of the British Lying-in Hospital London London    

1763 Powell Elizabeth William 40Officer of excise   of the HayCounty Brecknock x  

1763 Bevan Ann Richard 29   Neith

County Glamorgan, South Wales    

1764 Seyliard Mary Thomas 32Attorney

Serves as deputy matron through March 1766 Peckham x  

1764 Jones Elizabeth William 44Wheelwright   Old Brentford    1764 Guerrier Sarah William 34Tidesman   Dockhead Southwark    1765 Racketta Sarah Alexander 30Surgeon   Chester    

1765Featherstone Mary Frances

upwards of 30Mariner   Whitby York x  

1765 Langcake Ann John

about 35Taylor  

Windmill Street, London London    

1765 Goff Mary John

about 28Surgeon

From the late 1760s onwards, Mr. and Mrs. Goff advertised in the London press their lying-in hospital.

Pall Mall, London London    

Newspapers items relating to midwifery

 YEARS Midwife or

midwives or midwifery

Midwifery and lectures

Midwifery and course

Midwifery and pupils

Midwifery and students

1700-1709 99 - - - -

1710-1719 144 0 0 0 1

1720-1729 771 1 15 8 2

1730-1739 1092 8 19 13 25

1740-1749 834 5 7 1 19

1750-1759 1152 152 80 102 21

1760-1769 2541 56 29 36 9

1770-1779 2715 50 15 47 25

1780-1789 2944 181 170 167 53

1790-1799 2377 362 365 69 51

1800-1809 436 178 211 101 70

1810-1819 401 165 203 164 80

Classified ads . World (1787) (London, England), Friday,

March 12, 1790; Issue 996

• Dr. Osborn and Mr Clarke’s last Winter courses in Midwifery and the Diseases of Women and Children will begin as follows:

• The MORNING COURSE at No. 10, Queen Street, Golden-square, on Tuesday next, March 16, at half past Ten o’Clock.

• The EVENING COURSE, at No. 12, Chancery-lane, Fleet –street , (for the concenience of Gentlemen living near the City, or who cannot attend in the morning) on the folllowing Monday, March 22, at half past Five.

• Proposals may be had, and farther particulars known, by applying to Dr Osborn, Hanover-square; Mr.Clarke, Queen-street, Golden-square, or at the Lecture-room, in Chancery-lane.

MEDICAL EDUCATION IN 18th CENTURY LONDON

• No university, no centralised training• Private medical courses• Advertising in newspapers• Increasing opportunities for pupils to

gain practical experience in hospitals• 1700-1820 at least 234 men lecturing on

various medical subjects (Lawrence 1996)

• 1 in 5 taught midwifery• 33 midwifery teachers between 1700-

1800

MALE MIDWIFERY TEACHERSin 18th century London

LECTURER 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800

Batty

Pole

Hall with Squire

Squire ?

Thynne

Walsh

Dennison

BlandLowder with Haighton

Lowder with Orme

Rowley

Osborn with Clark

Denman with Osborn

Leake

Cooper ?

Krohn ? ?

Harvie

Bengough

Martin

MacKenzie

Orme and Lowder with Lowder

Orme

Crawford

MacDonough

Kelly

Exton

Hunter ? ?

Smellie

Parsons ?

Manningham ?

Griffi ths

Chapman

Maubray

YEAR 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800

MALE MIDWIFERY TEACHERSin 18th century London

LECTURER 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800

Batty

Pole

Hall with Squire

Squire ?

Thynne

Walsh

Dennison

BlandLowder with Haighton

Lowder with Orme

Rowley

Osborn with Clark

Denman with Osborn

Leake

Cooper ?

Krohn ? ?

Harvie

Bengough

Martin

MacKenzie

Orme and Lowder with Lowder

Orme

Crawford

MacDonough

Kelly

Exton

Hunter ? ?

Smellie

Parsons ?

Manningham ?

Griffi ths

Chapman

Maubray

YEAR 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800

• 33 teachers• Never more than 6• Most specialised• 14 linked to hospitals• Others: Homebirths• From 1 to over 30 years• From 9 to 24 lectures• Similar content (but two

camps!)• Very different teaching styles• Using ‘machines’ for

demonstrations • Different costs 3-10-20 guineas• Smellie – 900 men, 1150 mothers in 10 years• Many publications

MAN MIDWIVES: PUBLICATIONS

• John Maubray 1730• Richard Manningham 1744• William Smellie 1752• Brundell Exton 1766• John Leake 1767• William Hunter 1774• Thomas Denman 1782• Colin MacKenzie 1789• William Lowder 1789• William Osborn 1792• John Haighton 1799

RULES AND REGULATIONS

• Clear rules about costs and privileges

• Attending women at home or hospital

• Strong etiquette

‘… all conversation tending to excite apprehension in the patient be avoided, such as descriptions of bad labours, anatomical dissections, the state of their experience in obstetrical subjects, &c.’ (Haighton 1799)

MALE STUDENT EXPERIENCE

letters of Thomas Bishopp of Leister25 /5/1793Mr Cruikshank lectures have finished.

He has now ‘entered with Dr Clarke - the surgeon to study midwifery, as well as Dr Pearson’s lectures on physic, chemistry and materia medica from eight till half past ten in Leicester Square’.

There are no other lecturers on midwifery so nearer and anyway, Thomas 'should not be so well satisfied with any other'.

17/9/94'I am sorry to say that I have failed in every attempt I have made to get any private patients in midwifery’…

COMPLETION OF TRAINING

letters of Thomas Bishopp

7/11/1794

'I shall be sufficiently acquainted with practical dissection and anatomy to undertake all the common operations in surgery with good confidence in my qualification and I am not at all doubtful but that I understand the theory and practical department of midwifery as well as the majority of those who settle in the country.

 

Anatomy Dr Baillie and Mr Cruikshank 4 courses

Mr Cline 1 course - dissected 14 subjects , 2 for Dr Bailleys lectures

Physiology Dr Heighton 2 courses

Surgery Mr Hunter’s lectures by Home, 1 course

The practice of St Thomas’ , Guy’s, St Bartholomew’s and St George's hospitals successively for 4and a half years

Midwifery Dr Clarke and Dr Osborne 6 courses

Chemistry Dr Babington 2 courses

Botany Dr Smith 1 course

Physic Dr Fordyce lectures 1 courseDr Crichton lectures 1 course

Fordyce’s and the practice of the other physicians at St Thomas’ hospital 2 years.

During attendance at the above hospitals took down about 1500 medical and surgical cases.

Natural philosophy Mr walker 1 courseRev Mr Roberts 1 course

Took out a diploma at Surgeons Hall in 1795

FEMALE MIDWIVES• Jane Sharp 1671,

1724&5Knew Greek and Latin

• Sarah Stone 1737Three generations, trained in dissections

• Elizabeth Nihell 1760

Two years training in Hotel Dieu in Paris

• Margaret Stephen 1795

Trained by man midwife, pupil of Smellie

• Martha Mears 1797‘Spent some years under the most eminent

professors of midwifery’

• Jane Wright 1798Pupil at the British Lying in Hospital

EDUCATING FEMALE MIDWIVES in 18th c

LONDON• Some of the male teachers

offered courses to women• Different costs and

conditions• Women expressing

dissatisfaction about unfair treatment of female pupils

• When successful: proud to be trained by men

• Evidence of only one private midwifery school run by a woman to train female midwives: Margaret Stephen

Margaret Stephen: MIDWIFERY TEACHER

• ‘I teach my own pupils the anatomy of the pelvis… and of the foetal skull, on preparations which I keep by me, with everything else relative to practice in nature, at labours; also turning, and the use of the forceps, and other obstetric instruments, on a machine which I believe few teachers can equal… and I make them write whatever of my lectures may prove useful to them in their future practice, for which they are as well qualified as men.’ (p 4)

• ‘I intend to continue my lectures as usual to women entering upon the practice of midwifery, until the men who teach that profession render them unnecessary, by giving their female pupils as extensive instructions as they give the males’ (p 6)

Lying-in hospitals in 18th century London

New Westminster Lying-in Hospital 1765[Westminster Bridge Road]

Female pupils 1758

Female pupils 1753Female pupils 1758

Female pupils ?1809

Female pupils 1769

Exton, Denman, Khron, Heineken W.Hunter, Sandys, Layard, Kelly

Heineken, Ball, Grundy

MacDonough, Walsh

Leake, Brickenden, Harris

Female pupils 1739 First Lying in Facility: Manningham’s private rooms 1739-1744 [?Marylebone Road]

MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL

• Admitted from 1753• No more than 4-6 pupils at

one time• 3-6 months training• Resident in the hospital• High cost at 35 guineas• Taught by ‘Gentlemen of the

Faculty’• Delivering under the matron’s

and man-midwives’ supervision

• Certificate on completion

MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL

1753-1819 175

3-176

3

1764-

1773

1774-

1783

1784-

1793

1794-

1803

1804-

1813

1814-

1819

Total

 

Number of new pupils

38 38 25 19 30 28 7 185 

Range of admissio

ns per year

1-6 2-6 0-6 0-8 2-5 2-5 1-2 0-8

MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL

• Mean age 37, most in their 30s, range 20-60

• 2/3 married, 1/3 widows, few spinsters from 1780s

• 1/3 from London, 1/3 close to London, 1/3 far away – North, Ireland, Scotland, Jamaica

• Economically stable social backgrounds

British Hospital MIDWIFERY PUPILS

1753-1819: HUSBAND’S OCCUPATION

TOTAL1:10 wives of medical men

42% artisans/ craftsmen

29% tradesmen /skilled workers

7% Gentlemen/professionals

Jane Wright

• Wife of a wine merchant

• In London for 6 years

• Has practised much among poor gratis on the continent and at home

• Enrols as pupil at the British LI Hospital in 1797, aged 32

• Publishes pamphlet 1798

• Later serves as Matron at the Westminster Lying-in Hospital

Jane Wright 1798Jane had ‘taken much satisfaction, for years, to acquire knowledge in female diseases under able instructors both at home and abroad’.

Intends ‘to practise midwifery, being entitled to it by my liberal certificates, from the physicians and surgeons of the British Lying in hospital in Brownlow Street’.  She feels ‘sincerest obligations to them for their 'goodness and able instructions', as well as to the 'intelligent matrons of that useful charity' to whom she also offers her honest acknowledgements. (p 34)

THE LYING IN CHARITY FOR DELIVERING WOMEN

AT THEIR OWN HABITATIONS

1757

What was its role in training male and female midwives?

Further research is required

CONSEQUENCES?

• Enormous impact• Overly progressive

• Intrinsically regressive•Increasing control of training by men

•Removal from community to hierarchical institutions: embedding values of obedience

and conformity•Sub-servant role: less attractive to well-off

women

FROM PRIDE TO HUMILTY

18th century

Before the 18th century

Before the 18th century

End of 18th century

End of 18th century

Post-18th century

Post-18th century

Post-18th century